Effectiveness of first-generation HCV protease inhibitors: does HIV coinfection still play a role?

Eur J Gastroenterol Hepatol

aDepartment of Social Health (DISSAL), Division of Infectious Disease, University of Genoa-IRCCS San Martino-IST, Genoa bUnit of Infectious Diseases, Busto Arsizio Hospital, Busto Arsizio cEpi2004, Luigi Sacco Hospital dDepartment of Infectious Diseases, Luigi Sacco Hospital, Milan eInfectious Diseases Unit, AOU Careggi, Florence fInstitute of Infectious Disease, University of Bari, Bari gDepartment of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Catania hDivision of Infectious Diseases, 'Santo Spirito' Hospital, Pescara iDepartment of Clinical and Experimental Medicine, University of Sassari, Sassari jInfectious Diseases Unit, A. Manzoni Hospital, Lecco kInfectious Diseases Clinic, Università 'G. D'Annunzio', Chieti lUnit of Infectious Diseases, Santa Maria Annunziata Hospital, Firenze mDepartment of Infectious Diseases, Santa Maria Hospital, Perugia, Italy.

Published: January 2016

Objective: HIV/hepatitis C virus (HCV) coinfected patients are usually considered a difficult-to-treat population. The aim of this study was to assess the effectiveness of telaprevir-based and boceprevir-based treatments with respect to the HIV status.

Methods: A prospective multicentre study was conducted among 22 Infectious Disease centres in Italy. Demographic, HIV and HCV related variables were collected, as well as data on HCV viral decay, sustained virologic response (SVR12) and grade 3-4 adverse events.

Results: Overall, 162 patients (24.7% HIV/HCV coinfected) received HCV treatment. Out of 145 evaluable patients, 57.2% achieved SVR12 (49.5% monoinfected, 78.9% coinfected). HIV coinfection was associated with a slight increase in the probability of SVR12 (adjusted odds ratio 1.66, 95% confidence interval 0.59-4.64, P=0.33). Premature discontinuation rates and adverse events were similar irrespective of HIV status, with the exception of skin reactions, which were more frequently in the HIV group.

Conclusion: In a real-life setting, with a high proportion of cirrhotic and treatment-experienced patients, the overall SVR12 rate was 57.2%. HIV coinfection was not associated with impaired outcome.

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http://dx.doi.org/10.1097/MEG.0000000000000483DOI Listing

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